新型冠状病毒肺炎合并急性脑梗死一例

新型冠状病毒肺炎(COVID-19)为2019新型冠状病毒所致,其起病隐匿,潜伏期较长,具有高度传染性的特点。新型冠状病毒除了可累及呼吸系统,还可累及其他系统,如心脏、肾脏、消化道,并且可合并多个系统疾病,如急性脑血管病等,如果在接诊患者时不引起高度重视、做好防护,极易造成医护人员的感染。文中总结1例起病隐匿的COVID-19患者合并脑梗死症状,在行静脉溶栓治疗后造成1名医务人员感染的临床体会,探讨其临床特点、治疗经过并对其防控环节进行分析,以帮助疫情防控中首诊医生注意识别、减少漏诊、科学排查以减少职业感染。     

Bmi-1在神经系统发育和肿瘤发生中的作用和特点

人类许多肿瘤的发生都是基因异常调节的结果,神经肿瘤也不例外.研究表明,某些与发育相关的基因发生突变或调节异常可能会导致神经肿瘤的发生,最近发现的一种原癌基因Bmi-1(B lymphoma MO-MLV insertion region 1,Bmi-1)就是其中之一,它不仅参与胚胎的发育、多种干细胞的维持和自我更新,而且其过度表达可导致包括神经肿瘤在内的多种肿瘤的形成;Bmi-1缺失小鼠可表现为多种异常,如共济失调、血液疾病及神经疾病,表明Bmi-1具有多种生物学功能[1].     

肥厚性硬脑膜炎和硬脊膜炎3例报告

<正>肥厚性硬脑膜炎和硬脊膜炎是一种少见的慢性炎性纤维化疾病,分为特发性和继发性,可能与免疫相关。临床表现复杂多样,无特异性。外科活检是确诊的金标准,MRI有特征性表现可协助诊断,手术和糖皮质激素或免疫抑制剂治疗有效。现将近年来在我科诊治的3例肥厚性硬膜炎报道如下。1临床资料病例1:患者,男,14岁,学生。主因"头晕、头痛约1 y,加重10 d"于2014年4月入院。患者于1 y前无明显诱因出     

Shh-Gli信号激活对人神经母细胞瘤SK-N-AS细胞存活的影响及其机制

Shh作用使细胞凋亡率较对照组比较下降31%,周期检测显示Shh应用后,G0/G2期细胞百分比,从对照组61.81%下降至47.29%,S期从16.55%上升至45.66%,以上差异有统计学意义(P＜0.05).结论 激活Shh-Gli信号可减少SK-N-AS细胞的凋亡,加速其进入增殖周期,促进神经母细胞瘤的存活.     

CYP2C19 Polymorphism and Clinical Outcomes among Patients of Different Races Treated with Clopidogrel:A Systematic Review and Meta-Analysis

Several studies have investigated the association between CYP2C19 polymorphism and clinical outcomes of patients treated with clopidogrel, but few have noticed the difference in association between Westerners and Asians. We searched MEDLINE, EMBASE and Cochrane Library database and conducted a systematic review and meta-analysis. Thirty-six studies involving 44 655 patients with coronary artery disease(CAD) treated with clopidogrel were included, of which more than 68% had undergone percutaneous coronary intervention(PCI). The primary outcome of our interest was the recurrence of major adverse cardiovascular events(MACE) in those CAD patients. Firstly, we found that the distribution of reduced-function CYP2C19 allele varied between Westerners and Asians. Among Asians, 1 and 2 reduced-function CYP2C19 mutant allele carriers accounted for 42.5% and 10%, respectively. While among Westerners, 1 and 2 reduced-function CYP2C19 mutant allele carriers accounted for 25.5% and 2.4%, respectively. Secondly, the impact of CYP2C19 polymorphism on clinical outcomes of patients treated with clopidogrel varied with races. Among Asians, only 2 reduced-function CYP2C19 mutant allele carriers had the reduced effect of clopidogrel. And the reduced effect was significant only after the 30 th day of treatment. While among Westerners, both 1 and 2 reduced-function CYP2C19 allele carriers had the reduced effect, and it mainly occurred within the first 30 days. Thirdly, the safety of clopidogrel was almost the same among races. Reduced-function allele non-carriers had higher risk for total bleeding but did not have higher risk for major bleeding. It is suggested that CYP2C19 polymorphism affects the efficacy of clopidogrel differently among Westerners and Asians.     

Bmi-1在神经母细胞瘤中的表达及意义

目的 通过检测原癌基因Bmi-1在神经母细胞瘤(NB)中的表达以及观察其表达水平对神经母细胞瘤的影响,探讨其在神经母细胞瘤中的作用.方法 用免疫组织化学和免疫印迹法检测方法分别检测人神经母细胞瘤标本和神经母细胞瘤细胞系细胞中Bmi-1的表达情况;采用逆转录病毒转染法将目的基因Bmi-1/si转染至Ⅰ型神经母细胞瘤细胞系BE-2-C细胞,通过Western免疫印迹法监测转染效果,并用软琼脂实验观察转染后的BE-2-C克隆形成能力.结果 在32例人神经母细胞瘤标本中29例有Bmi-1的高表达(90.63%),且Bmi-1的表达程度的高低和NB的临床分期和临床预后密切相关(P＜0.05),Western免疫印迹实验也显示9种不同病理类型的神经母细胞瘤细胞系细胞中均有Bmi-1的高表达,其表达水平和病理类型有密切相关.在软琼脂实验中,与对照组(空白载体转染组)比较,Bmi-1/si转染后的BE-2-C细胞所形成的克隆数目不仅显著减少,克隆也明显变小.结论 Bmi-1在神经母细胞瘤中高表达,其表达水平与肿瘤恶性程度密切相关,它在神经母细胞瘤的形成中起重要作用.     

EphB/Ephrin-B1信号对睫状神经节α7-尼古丁乙酰胆碱受体电流的影响

目的 探讨EphB/Ephrin.B1信号对鸡胚睫状神经节(CG)神经元上α7-尼古丁乙酰胆碱受体(α7-nAChRs)电流的影响. 方法用膜片钳技术分别在培养的和急性分离的CG神经元上记录α7-nAChRs电流.细胞被随机分为:对照组、Ephrin-BlFc处理组、IgG处理组和Ephrin-B1处理组,观察电流的变化. 结果对照组、lgG组和Ephrin-B1处理组之间α7-nAChRs电流无显著差异(P>0.05),而这3组与Ephrin-BlFc处理组之间有显著差异(P<0.05).Ephrin-BlFc可浓度依赖性抑制α7-nAChRs电流,该过程可在数分钟内发生,并呈现可逆性.培养的和急性分离的CG神经元Ipeak/Cm的IC50分别为0.032mg/L和1.4mg/L. 结论 Eph/Ephrin-Bl信号町影响CG神经元α7-nAChRs的电流,提示Eph/Ephrin-Bl可能参与交感神经系统功能的调控.     

曲唑酮治疗失眠、抑郁及焦虑并存患者临床观察

目的:通过门诊和住院患者使用曲唑酮后睡眠情况的观察,评价曲唑酮治疗失眠、抑郁和焦虑的临床价值。方法:将患有失眠、抑郁及焦虑的患者60例分为A、B、C三组,每组20例,分别采用阿米替林、曲唑酮50mg、曲唑酮100mg治疗。采用汉密尔顿焦虑抑郁量表和匹兹堡睡眠量表检测,睡眠日记记录睡眠质量,比较三组治疗效果。结果:在总睡眠时间、睡眠潜伏期、觉醒次数、停用艾司唑仑时间等方面B组和C组均优于A组。结论:曲唑酮治疗失眠、焦虑及抑郁并存患者有显著疗效。     

Activation of sonic hedgehog signaling pathway in S-type neuroblastoma cell lines

The effects of Sonic hedgehog(Shh) signaling pathway activation on S-type neuroblastoma(NB) cell lines and its role in NB tumorigenesis were investigated.Immunohistochemistry was used to detect the expression of Shh pathway components- Patched1(PTCH1) and Gli1 in 40 human primary NB samples.Western blotting and RT-PCR were used to examine the protein expression and mRNA levels of PTCH1 and Gli1 in three kinds of S-type NB cell lines(SK-N-AS,SK-N-SH and SHEP1),respectively.Exogenous Shh was administrated to ...     

Cyclopamine对神经母细胞瘤细胞系SK-N-SH细胞生长周期的影响及其机制

目的探讨Shh信号途径的抑制剂cyclopamine对人神经母细胞瘤细胞系SK-N-SH细胞生长周期的影响及其分子生物学机制。方法以不同浓度的cyclopamine处理SK-N-SH细胞不同时间,在相差倒置显微镜下观察药物作用后的该细胞形态学变化。用四甲基偶氮唑盐（MTT）分析法检测各组SK-N-SH细胞的增殖情况,流式细胞仪检测不同浓度cyclopamine作用后对细胞周期的影响,Westernblot检测药物作用前后细胞周期蛋白D1、P16和P21蛋白表达的变化。结果cyclopamine各处理组SK-N-SH细胞形态学有所不同。MTT法检测结果显示,cyclopamine对SK-N-SH细胞增殖的抑制是浓度依赖性和时间依赖性的（P〈0.05）。流式细胞仪检测发现随着药物浓度的增加,G0/G1期细胞百分比明显增加（P〈0.05）,而S期细胞百分比明显降低（P〈0.05）。Westernblot检测结果显示,随着药物浓度的增加,SK-N-SH细胞中细胞周期蛋白D1表达逐渐降低,P16和P21表达逐渐增高（P〈0.05）。结论cyclopamine抑制SK-N-SH细胞生长,阻滞细胞从G1期向S期转化,其机制可能与调控细胞周期蛋白表达有关。cyclopamine可能成为未来治疗神经母细胞瘤的药物之一。